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Vol:.(1234567890)
Clinical Child and Family Psychology Review (2020)
23:176–204https://doi.org/10.1007/s10567-019-00307-y
1 3
Parents’ Perceptions and Experiences of Parenting
Programmes: A Systematic Review and Metasynthesis
of the Qualitative Literature
J. Butler1,2 · L. Gregg1 ·
R. Calam1 · A. Wittkowski1,2
Published online: 10 December 2019 © The Author(s) 2019
AbstractSupporting parents to meet the challenges of their
caregiving role is identified as a public health concern and a
priority in policies internationally. Quantitative research has
established the efficacy of parenting programmes but less is
understood about the key aspects that make interventions meaningful
and helpful to families. We aimed to explore parents’ experiences
and perceptions of parenting programmes in order to highlight the
parent voice and identify key factors that parents perceive to be
meaningful and improve our understanding of the acceptability and
perceived benefits of parenting programmes. Six key electronic
databases were searched systematically for qualitative research and
eligibility for inclusion was established. A thematic synthesis was
undertaken. Twenty-six studies were included, spanning
17 years of parenting research and involv-ing 822 parents.
Three main themes and nine subthemes were identified: (1) a
family’s journey (prior to the parenting pro-gramme, outcomes
(including changes in the parent, child and wider family) and
post-intervention), (2) aspects perceived to be important or
valuable (group leader or facilitator, programme content and
delivery and value of the group) and (3) challenges or difficulties
(barriers to engagement or attendance, programme content and
suggestions for improvement). Reported outcomes of parenting
programmes included changes in the parent alongside changes in the
child and family more widely. Key recommendations to improve
provision of accessible, clinically and cost-effective
interventions for parents include ensuring high-quality training
and supervision of facilitators, balancing flexibility and fidelity
to ensure tailored content to meet individual needs, a sensitivity
to parental adversity, the need for wider familial support and the
availability of ongoing support following the end of a parenting
programme.
Keywords Metasynthesis · Thematic analysis ·
Acceptability · Feasibility · Parent training ·
Parenting · Qualitative
Introduction
Parenting strongly influences a child’s early life experiences
and the trajectory of their cognitive, emotional, behavioural and
social development across the life course (Britto et al. 2015;
Leadsom et al. 2014). Supporting parents to meet the
challenges of their caregiving role has consistently been
identified as a public health concern; it remains a priority
within international policy (Heckman 2017; Hodgkin and Newell
2007; O’Connell et al. 2009) and is considered to be a form of
social investment with far-reaching social and economic
implications (Balbernie 1999; Heckman 2017; Sandler et al.
2011).
Substantial evidence suggests parenting interventions, often
based on social learning theory principles, have the potential to
provide clinically and cost-effective methods to improve the health
and well-being of parents and chil-dren (Barlow and Coren 2018;
Barlow et al. 2003, 2014). A growing body of research provides
evidence that parenting programmes can be effective in improving
parental mental health and psychosocial functioning (Barlow
et al. 2014) and improving educational (Hallam et al.
2006), emotional and behavioural outcomes amongst children (Barlow
et al. 2005). The economic argument for early intervention as
a means of breaking the cycle of disadvantage has also been made
convincingly (Allen 2011; Bauer et al. 2014).
* A. Wittkowski [email protected]
1 Division of Psychology and Mental Health, School
of Health Sciences, Faculty of Biology, Medicine
and Health, The University of Manchester, Manchester
Academic Health Science Centre, Zochonis Building, Brunswick
Street, Manchester M13 9PL, England, UK
2 Greater Manchester Mental Health NHS Foundation Trust,
Manchester, UK
http://orcid.org/0000-0003-3806-0183http://crossmark.crossref.org/dialog/?doi=10.1007/s10567-019-00307-y&domain=pdf
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177Clinical Child and Family Psychology Review (2020)
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Research to date has largely focused on quantitative out-comes,
establishing the efficacy of parenting interventions and providing
a rationale for widespread implementation. However, evidence-based
policy on parenting has proved difficult to implement (Law
et al. 2009). A key challenge for the ‘real world’ delivery of
clinically and cost-effective parenting programmes is to engage
parents to participate and maximise retention (Axford et al.
2012; Bumbarger and Per-kins 2008; Mytton et al. 2014). Lack
of parental engagement compromises the extent to which parenting
programmes are able to offer valued outcomes (Morawska and Sanders
2006). Furthermore, parents with the greatest potential to benefit
may be the least likely to engage (Barrett 2010). Historically,
there has been a paucity of empirical evidence examining factors
relating to engagement and participation (Morawska and Sanders
2006), the successful implementa-tion of accessible, evidence-based
parenting interventions is dependent on process-orientated insights
rather than just outcome data.
More recently, factors influencing parental engagement and
retention has been given greater consideration (Dup-pong-Hurley
et al. 2016; Ingoldsby 2010). Examination of the facilitators
and barriers that may exist for parents has highlighted some
important considerations for effective and accessible delivery of
parenting programmes (Koerting et al. 2013; Miller and Prinz
2003; Mytton et al. 2014). However, previous reviews have been
limited by small numbers of included studies (Koerting et al.
2013). Moreover, there is a need to go further than the examination
of factors that may help and hinder parents in engaging with
parenting programmes. Preliminary work has begun to consider the
mechanisms by which such parenting programmes bring about
improvements for parents and children (Holtrop et al. 2014).
Exploring the perceptions and experiences of parents qualitatively
has the potential to identify the key aspects or possible
mechanisms of change that make such interven-tions meaningful and
helpful to families (Kane et al. 2007). Qualitative analysis,
which allows for the identification of the ‘critical ingredients’
that contribute to the success of par-enting programmes under ‘real
world’ conditions (Furlong and McGilloway 2012; Law et al.
2009), has the potential to enhance our understanding of how to
adapt parenting inter-ventions to meet parents’ needs, maximise
retention and improve outcomes (Furlong and McGilloway 2012;
Holtrop et al. 2014).
A systematic review of four qualitative studies by Kane
et al. (2007) appears to have been the only metasynthesis of
qualitative studies to date to examine parents’ experiences and
perceptions of parenting programmes in order to articu-late more
clearly what makes these interventions meaningful to parents. This
review identified key concepts: “the acquisi-tion of knowledge,
skills and understanding, together with feelings of acceptance and
support from other parents in the
parenting group, enabled parents to regain control and feel more
able to cope. This led to a reduction in feelings of guilt and
social isolation, increased empathy with the children and
confidence in dealing with their behaviour” (Kane et al. 2007,
p. 789). However, that review only included four stud-ies of
group-based parenting programmes in Western cul-tures for children
with behavioural problems. As there has been a significant growth
of the qualitative literature within recent years driven by the
recognised value of routinely seeking the views and experiences of
participants during the evaluation of parenting programmes (Mytton
et al. 2014), it is timely to undertake a further and more
comprehensive review of qualitative research in this area.
In line with the Medical Research Council (MRC) pro-cess
evaluation framework (Moore et al. 2015), a system-atic review
and metasynthesis of qualitative literature would inform the
development of new parenting programmes or the adaptation of
existing programmes to ensure provision of parenting programmes
that can meet the needs of par-ents and caregivers, engage and
retain them in the process and enhance implementation procedures to
ensure delivery is clinically and cost effective. Consequently, the
current review seeks to examine what the experiences of parents and
carers of parenting programmes were. Thus, the aims of the current
review were to (1) provide an overview of parents’ and carers’
experiences of parenting programmes, (2) high-light the parent
voice and identify key aspects of parenting programmes parents and
carers perceive to be of value or not, (3) to improve our
understanding of the acceptability and perceived benefits of
parenting programmes.
Methods
Search Strategy and Identification of Studies
The SPIDER tool (Sample, Phenomenon of Interest, Design,
Evaluation, Research Type) (Cooke et al. 2012) was used to
develop the search strategy (see Table 1). A systematic
liter-ature search of six key electronic databases was undertaken
(Applied Social Sciences Index and Abstracts (ASSIA), Medline,
PsycInfo, CINHAL Plus, EMBASE and Web of Science Core Collection)
from inception to the present date. Databases were searched (on
30/07/2018) for articles con-taining these terms in either the
title, abstract or keywords. The review protocol was registered
with the PROSPERO international prospective register of systematic
reviews (http://www.crd.york.ac.uk/prosp ero, registration number
CRD42018116358).
Figure 1 presents an outline of the search process based on
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines (Moher et al. 2009). The initial screening
of titles and abstracts was carried out
http://www.crd.york.ac.uk/prospero
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Table 1 Search terms and limits1. S—sample (parent* OR mother*
OR father* OR famil* OR carer*)2. PI—phenomenon of interest
(training OR intervention* OR program* OR education* OR
group* OR approach*)3. D—design (perce* OR perspective* OR
opinion* OR experience* OR
belie* OR view* OR attitude*)4. E—evaluation (interview* OR
focus group* OR questionnaire* OR survey*)5. R—research type
(qualitative OR mixed method)6. 1 AND 2 AND 37. 4 OR 58. 6 AND
7Limits Humans & English language
Fig. 1 PRISMA flow diagram
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179Clinical Child and Family Psychology Review (2020)
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by one reviewer (JB). A sample (15%) was screened by a second
reviewer, independent of the research team (HA). Agreement between
reviewers was 98.05%. At the full text screening stage, the first
author (JB) scrutinised all papers against inclusion criteria and
in the instance of uncertainty, two other authors (AW and LG)
jointly scrutinised to reach agreement. Any uncertainty regarding
eligibility was resolved via discussion with the research team.
Inclusion and Exclusion Criteria
Papers were included if they (1) were written in English, (2)
used qualitative methods of data collection (specifically
interviews or focus groups) and analysis, (3) involved par-ents or
caregivers who had attended or been invited to attend a parenting
programme, (4) focused on parents’ views, expe-riences or
perceptions of parenting programmes and (5) were published in a
peer-reviewed journal.
Drawing upon a number of differing definitions of par-enting
programmes offered in the literature, the following criteria were
adopted for inclusion in the current review: Interventions aimed at
(1) improving parenting practices, family functioning and promoting
the social and emotional well-being of children (Smith et al.
2002), (2) providing training, support or education including
active skills train-ing or coaching to parents (Mejia et al.
2012), (3) delivered in a group-setting or individually, (4)
engaging parents of children aged 0–16 years. Papers were
included if parents or caregivers had attended or been invited to
attend a parenting programme.
Papers were excluded if the parenting programme was aimed
specifically at parents of children identified as hav-ing Autism
Spectrum Disorder (ASD), a learning disability or a physical
disability. This decision was taken as there is substantial
research evidence to suggest that the expe-riences and challenges
faced by these parents are distinct from those parents of children
without identified significant additional needs (Bourke-Taylor and
Jane 2018). Whilst it is acknowledged that other populations of
parents may also face unique parenting challenges, the current
review sought to consider the experiences of a wide range of
parents and identify possible commonalities in their experiences of
par-enting programmes.
Quality Assessment
The quality of included studies was assessed by one reviewer
(JB) using the 10-item Critical Appraisal Skills Programme (CASP)
checklist for qualitative studies (available from https
://casp-uk.net), a widely used quality assessment tool for
assessing qualitative research. In order to summarise quality
ratings concisely and provide a useful indicator for compari-son
the items on the CASP checklist were also attributed
a numerical outcome (No = 0, Can’t Tell = 0.5, Yes = 1),
resulting in a maximum total score of 10. The total CASP score for
all papers was used to categorise the methodologi-cal quality as
either ‘high’ (> 8–10), moderate (6–8) or low (≤ 5). In order to
assess the reliability of quality assessment ratings 25% of the 26
included papers were rated by an inde-pendent reviewer (HA).
Agreement between raters was high (95.71%, kappa = 0.87) and any
disagreement was resolved via discussion.
Thematic Synthesis
Thematic analysis, an approach often used to analyse pri-mary
qualitative data (Braun and Clarke 2006), has also been identified
as an appropriate method to synthesise the findings of multiple
qualitative studies (Thomas and Harden 2008). The approach was
selected for use in the present review because it combines and
adapts approaches from meta-ethnography (Noblit and Hare 1988) and
grounded theory (Corbin and Strauss 2015; Eaves 2001), and has
identified utility in allowing questions related to the
appro-priateness and acceptability of interventions to be addressed
in order to inform policy and practice (Barnett-Page and Thomas
2009; Tong et al. 2012). The development of ana-lytical themes
allows the synthesis to ‘go beyond’ the con-tent of the original
studies and generate additional concepts or understandings (Thomas
and Harden 2008; Thorne et al. 2004). The epistemological
stance adopted in the current review was most closely aligned to a
critical realist perspec-tive (Fletcher 2017).
The three stages of thematic synthesis as outlined by Thomas and
Harden (2008) were used: (1) Free line-by-line coding of the
findings of primary studies, (2) the organisa-tion of ‘free codes’
into related areas to construct descrip-tive themes and (3),
finally, the development of analytical themes. All text under the
headings ‘results’ or ‘findings’ were extracted electronically and
entered into NVivo soft-ware (QSR International Pty Ltd. Version
12, 2018) in which data were subsequently organised ready for
analysis. Com-parisons were made within and across studies, meaning
sub-sequent studies were coded into pre-existing codes and new
codes were created when necessary. The process of coding and
developing descriptive and analytical themes was done inductively,
allowing these to emerge from the data. Guided by an experienced
reviewer and clinician (AW), all stages were undertaken by the
first author (JB), a white, British woman who was a trainee
clinical psychologist with experi-ence of delivering evidence-based
parenting programmes. The plausibility and coherence of themes was
established via review by a researcher independent to the process
(RF) and via scrutiny be the research team to ensure codes and
themes were appropriately derived from the data and potential bias
was minimised. Guidelines enhancing the transparency in
https://casp-uk.nethttps://casp-uk.net
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180 Clinical Child and Family Psychology Review (2020)
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reporting the synthesis of qualitative research (ENTREQ) were
adhered to (Tong et al. 2012: see Table 4 for completed
checklist).
Results
Characteristics of Included Studies
A total of 26 studies was identified for inclusion in the
cur-rent review as summarised in Table 2. Despite no time
limit being applied to the search, included studies were all
con-ducted in or after between 2001. They considered a variety of
parenting programmes, the most frequently cited being (1) the
Triple P Positive Parenting Programme, including groups, seminars
and amended versions of Triple P (n = 7) (Coates et al. 2017;
Cullen et al. 2013; Errázuriz et al. 2016; Garcia
et al. 2018; Haskett et al. 2018; Houlding et al.
2012; Lewis et al. 2016), (2) Webster-Stratton’s Incredible
Years Parent Training Program (n = 6) (and 3) Strengthening
Fami-lies Program 10–14 (n = 3) Twenty-five of the included
stud-ies referred to parenting programmes delivered in a group
format with only one being delivered individually. Studies were
conducted in the United States (n = 10), the United Kingdom (n =
8), Canada (n = 2), Panama (n = 2), Ireland (n = 2), Australia (n =
1) and Chile (n = 1).
Whilst a number of the included studies employed a range of
methods of data collection, qualitative data were derived from
interviews (n = 20) or focus groups (n = 6). In six of the included
studies it was possible to identify that qualita-tive data had been
collected as part of a larger randomised control trial. The most
common methods of analysis were Grounded Theory (n = 9), Thematic
Analysis (n = 5) and Interpretive Phenomenological Analysis (n =
4). A number of studies (n = 3) did not specify the method of
analysis used but described the analytical process used. The sample
sizes of the 26 included studies were diverse, ranging from n = 5
(Wilson et al. 2018) to n = 166 (Hartwig et al. 2017).
The review includes data from a total of 822 parents.
Interven-tions included in the review were offered to a variety of
parents including specific sub-groups (e.g. parents expe-riencing
mental health difficulties, homelessness, parents involved in
child-welfare agencies, lone parents and low-income parents).
Methodological Quality of Included Studies
Overall, the methodological quality of all included studies was
deemed either high (n = 22) or moderately high (n = 4) (see
Table 3 for details). However, there were a number of issues
that were identified. There were only six studies (23%) in which
the relationship between researcher and par-ticipant had been
adequately considered and reported. In
eleven (42%) of the included studies approval by an ethics
committee was not evidenced and in four (15%) of these, there was
no evidence that ethical issues had been taken into
consideration.
Given that there is not a widely accepted or empirically tested
approach for excluding qualitative studies from syn-thesis on the
basis of quality (Dixon-Woods et al. 2006; Thomas and Harden
2008), no studies were excluded.
Thematic Synthesis
Three main themes were developed during the synthesis
representing different aspects of parents’ perceptions and
experiences of parenting programmes: (1) a family’s jour-ney, (2)
aspects perceived to be important or valuable and (3) challenges or
difficulties. A family’s journey included subthemes relating to
perceptions and experiences prior to the parenting programme;
outcomes associated with the parenting programme and
post-intervention experi-ences. Outcomes included changes in the
parent (includ-ing overcoming barriers to engagement, skill
development, developing understanding and relationship with the
child, improved well-being and view of self), alongside changes in
the child and family more widely. Aspects of the par-enting
programmes perceived to be important or valuable included factors
related to the group leader or facilitator, programme content and
delivery and the group. Subthemes included within challenges and
difficulties associated with the parenting programme included
barriers to engagement or attendance, programme content and
suggestions parents made for improving the programme. A detailed
matrix of themes is presented in Table 5, illustrating which
themes were present in the 26 included studies. The themes and
their relation to one another are depicted in Fig. 2. A
fam-ily’s journey through a parenting programme is influenced by
their experience of the aspects perceived to be important or
valuable and the challenges and difficulties they face in engaging
in such programmes. Moreover, it is hypothesised that the outcomes
associated with changes in the parent have a reciprocal
relationship with changes in child and family more widely.
Theme 1: A Family’s Journey
Subtheme 1.1: Prior to the Parenting Programme
This subtheme related to the experiences and perceptions of
parents prior to commencing a parenting programme. Par-ents
described experiencing a range of difficulties including problems
managing their child’s behaviour, problems in the relationship with
their child, frequent distressing interac-tions with their child
and feeling isolated. Parents commonly described a sense of
helplessness, desperation and feeling
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181Clinical Child and Family Psychology Review (2020)
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1 3
Tabl
e 2
Cha
ract
erist
ics o
f inc
lude
d stu
dies
Aut
hors
, pub
licat
ion
year
, cou
ntry
Aim
s/ob
ject
ives
/rese
arch
qu
estio
nsPa
rtici
pant
saIn
terv
entio
nD
ata
colle
ctio
nbM
etho
d of
ana
lysi
sM
ain
them
es id
entifi
edc
1W
ilson
et a
l. (2
018)
, UK
(1) E
xam
ine
the
pare
nt-
ing
and
help
-see
king
ex
perie
nces
of p
aren
ts
affec
ted
by p
erso
nalit
y di
sord
er, (
2) e
xplo
re
the
acce
ptab
ility
of
Hel
ping
Fam
ilies
Pr
ogra
mm
e to
this
po
pula
tion,
(3) r
efine
th
e pr
otoc
ol fo
r the
su
bseq
uent
pilo
t RC
T
N =
5 m
othe
rs (w
ho m
et
diag
nosti
c cr
iteria
for
pers
onal
ity d
isor
der
and
thei
r chi
ldre
n m
et c
riter
ia fo
r a
beha
viou
ral a
nd/o
r em
otio
nal p
robl
em)
Hel
ping
Fam
ilies
Pro
-gr
amm
e(D
ay e
t al.
2011
)
Sem
i-stru
ctur
ed in
ter-
view
sIn
terp
retiv
e ph
enom
eno-
logi
cal a
naly
sis (
Smith
an
d O
sbor
n 20
08)
(1) T
he e
xper
ienc
e of
pa
rent
hood
, (2)
Bei
ng
a pa
rent
affe
cted
by
pers
onal
ity d
isor
der,
(3)
Expe
rienc
e of
the
inte
r-ve
ntio
n, (4
) Qua
litie
s of
help
ing
2G
arci
a et
al.
(201
8),
USA
(1) W
hat i
nner
and
out
er
cont
extu
al fa
ctor
s in
fluen
ce a
cces
s to
and
activ
e en
gage
men
t in
Trip
le P
?, 2
) To
wha
t ex
tent
do
they
bel
ieve
Tr
iple
P is
effe
ctiv
e in
ad
dres
sing
chi
ldre
n’s
mal
adap
tive
beha
v-io
urs a
nd p
rom
otin
g po
sitiv
e pa
rent
–chi
ld
inte
ract
ions
?
N =
35 p
aren
ts (a
ged
20–4
9 ye
ars)
refe
rred
to
chi
ld-w
elfa
re a
gen-
cies
Gro
up T
riple
P(h
ttps :
//ww
w.tri
pl ep
.net
)In
terv
iew
& F
ocus
G
roup
sG
roun
ded
theo
ry
(Stra
uss a
nd C
orbi
n 19
90)
(1) B
arrie
rs to
eng
age-
men
t, (2
) Ove
rcom
ing
barr
iers
to e
ngag
emen
t, (3
) Effe
cts o
f eng
age-
men
t: N
ew in
sigh
ts a
nd
actio
ns a
bout
effe
ctiv
e pa
rent
ing
3H
aske
tt et
al.
(201
8),
USA
To e
xam
ine
the
degr
ee
to w
hich
par
ents
exp
e-rie
ncin
g ho
mel
essn
ess
cons
ider
ed T
riple
P
cont
ent,
mat
eria
ls a
nd
deliv
ery
met
hods
to b
e re
leva
nt a
nd h
elpf
ul
N =
16 p
aren
ts e
xper
i-en
cing
hom
eles
snes
sTr
iple
P S
emin
ar(h
ttps :
//ww
w.tri
pl ep
.net
)Fo
cus g
roup
sC
onte
nt a
naly
sis (
Flic
k 20
14)
(1) R
elev
ance
of t
he
Trip
le P
sem
inar
to
the
pare
ntin
g ex
peri-
ence
in sh
elte
rs, (
2)
Pare
ntin
g re
flect
ions
an
d ch
alle
nges
, (3)
Pa
rent
s’ o
pini
ons a
bout
th
e se
min
ar fo
rmat
and
m
ater
ials
, (4)
Par
ents
re
com
men
ded
chan
ges
to th
e se
min
ar4
Coa
tes e
t al.
(201
7),
Aus
tralia
To g
ain
the
pers
pect
ives
of
par
ents
who
hav
e co
mpl
eted
the
prog
ram
N =
18 p
aren
ts se
lf-id
entif
ying
as h
avin
g a
men
tal h
ealth
diffi
culty
Men
tal H
ealth
Pos
itive
Pa
rent
ing
Prog
ram
(M
HPP
P) (P
hela
n et
al.
2013
)
Sem
i-stru
ctur
ed te
l-ep
hone
inte
rvie
ws
Them
atic
ana
lysi
s (B
raun
and
Cla
rke
2006
)
(1) B
eing
in a
gro
up w
ith
othe
rs w
ith m
enta
l ill
ness
, (2)
Foc
us o
n ch
ild d
evel
opm
ent a
nd
pare
ntin
g w
ith a
men
tal
illne
ss, (
3) T
he h
ome
visi
ts
https://www.triplep.nethttps://www.triplep.net
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182 Clinical Child and Family Psychology Review (2020)
23:176–204
1 3
Tabl
e 2
(con
tinue
d)
Aut
hors
, pub
licat
ion
year
, cou
ntry
Aim
s/ob
ject
ives
/rese
arch
qu
estio
nsPa
rtici
pant
saIn
terv
entio
nD
ata
colle
ctio
nbM
etho
d of
ana
lysi
sM
ain
them
es id
entifi
edc
5H
artw
ig e
t al.
(201
7)*,
U
SATo
allo
w p
artic
ipan
ts
to d
escr
ibe
thei
r ex
perie
nce
with
the
prog
ram
me
in th
eir
own
wor
ds a
nd e
xam
-in
e ho
w p
artic
ipat
ing
mot
hers
des
crib
ed
pare
ntin
g fo
llow
ing
invo
lvem
ent i
n th
e pr
ogra
m
N =
166
low
-inco
me
mot
hers
, pre
dom
i-na
ntly
His
pani
c an
d B
lack
Lega
cy fo
r Chi
ldre
n (K
amin
ski e
t al.
2013
)Fo
cus G
roup
sG
roun
ded
theo
ry (H
en-
nink
et a
l. 20
11)
(1) C
omm
itmen
t to
par-
entin
g, (2
) Nur
tura
nce
&
sens
itivi
ty/re
spon
sivi
ty,
(3) P
aren
tal c
ontro
l, (4
) D
evel
opm
enta
l stim
ula-
tion
6Er
rázu
riz e
t al.
(201
6),
Chi
leEv
alua
te th
e fe
asib
il-ity
of i
mpl
emen
ting
Trip
le P
in C
hile
, and
to
ass
ess i
ts so
cial
and
cu
ltura
l acc
epta
bilit
y,
the
leve
l of i
nvol
ve-
men
t of f
amili
es, t
he
costs
invo
lved
, and
the
impa
ct o
f chi
ldre
n an
d th
eir f
amili
es
N =
34 p
aren
t atte
ndin
g pr
imar
y ca
re c
entre
s in
Sant
iago
de
Chi
le
Gro
up T
riple
P(h
ttps :
//ww
w.tri
pl ep
.net
)Fo
cus g
roup
sG
roun
ded
theo
ry
(Stra
uss a
nd C
orbi
n 20
02)
(1) I
mpa
ct o
f the
pro
gram
: re
-lear
ning
how
to
pare
nt, r
elat
ions
hip
with
chi
ldre
n, fa
mily
dy
nam
ics,
chan
ges i
n ch
ildre
n, (2
) Pro
gram
im
plem
enta
tion:
mat
eri-
als a
nd a
ctiv
ities
, hom
e ex
erci
ses,
child
car
etak
-er
s, su
gges
tions
7D
uppo
ng-H
urle
y et
al.
(201
6), U
SA(1
) To
lear
n ab
out b
ar-
riers
to p
artic
ipat
ion
face
d by
fam
ilies
who
ha
d en
rolle
d in
, but
ne
ver o
r min
imal
ly
atte
nded
, a c
omm
u-ni
ty- b
ased
par
entin
g pr
ogra
m, (
2) G
athe
r fe
edba
ck fr
om th
ese
pare
nts w
ho d
id n
ot
parti
cipa
te in
the
smal
l-gro
up p
aren
t-in
g cl
ass r
egar
ding
th
eir p
ersp
ectiv
e ab
out
alte
rnat
ive,
web
-bas
ed
met
hods
of d
eliv
ery
N =
27 p
aren
ts w
ho
sign
ed u
p fo
r but
di
d no
t com
plet
e a
com
mun
ity-b
ased
pa
rent
ing
prog
ram
Com
mon
-Sen
se P
aren
t-in
g (h
ttps :
//ww
w.bo
yst
own.
org/
pare
n tin
g/Pa
ges /
com
mo n
-sen
se
-par
en tin
g.as
px)
Sem
i-stru
ctur
ed te
l-ep
hone
inte
rvie
ws
Not
spec
ified
(1) R
easo
ns fo
r reg
ister
ing
for t
he p
aren
t pro
gram
, (2
) Bar
riers
to a
ttend
ing
the
pare
ntin
g pr
ogra
m,
(3) W
hat w
ould
hav
e he
lped
the
pare
nts a
ttend
th
e pr
ogra
m
8Le
wis
et a
l. (2
016)
, USA
To e
xplo
re c
hild
-wel
fare
in
volv
ed p
aren
ts’
perc
eptio
ns o
f the
re
leva
nce
and
fit o
f Pa
thw
ays T
riple
P, t
o th
eir n
eeds
N =
47 p
aren
ts in
volv
ed
with
the
stat
e ch
ild-
wel
fare
age
ncy
Path
way
s Trip
le P
(http
s ://w
ww.
tripl
ep.n
et)
Sem
i-stru
ctur
ed in
ter-
view
sTh
emat
ic A
naly
sis
(fra
mew
ork
met
hod)
(R
itchi
e an
d Le
wis
20
03)
(1) P
rogr
am c
onte
nt, (
2)
Prog
ram
mat
eria
ls, (
3)
Prog
ram
stru
ctur
e, (4
) En
dors
emen
ts, (
5) B
ar-
riers
to p
artic
ipat
ion
https://www.triplep.nethttps://www.boystown.org/parenting/Pages/common-sense-parenting.aspxhttps://www.boystown.org/parenting/Pages/common-sense-parenting.aspxhttps://www.boystown.org/parenting/Pages/common-sense-parenting.aspxhttps://www.boystown.org/parenting/Pages/common-sense-parenting.aspxhttps://www.triplep.net
-
183Clinical Child and Family Psychology Review (2020)
23:176–204
1 3
Tabl
e 2
(con
tinue
d)
Aut
hors
, pub
licat
ion
year
, cou
ntry
Aim
s/ob
ject
ives
/rese
arch
qu
estio
nsPa
rtici
pant
saIn
terv
entio
nD
ata
colle
ctio
nbM
etho
d of
ana
lysi
sM
ain
them
es id
entifi
edc
9M
ejia
et a
l. (2
016)
, Pa
nam
aTo
exp
lore
par
enta
l per
-ce
ptio
ns o
f cul
tura
l fit
N =
30 P
anam
ania
n pa
r-en
ts o
f ado
lesc
ents
Stre
ngth
enin
g fa
mili
es
prog
ram
me
(SFP
) 10
-14
(Mol
gaar
d an
d Sp
oth
2001
)
Sem
i-stru
ctur
ed in
ter-
view
sTh
emat
ic A
naly
sis
(Bra
un a
nd C
lark
e 20
06)
(1) C
omm
unic
atio
n, (2
) Re
silie
nce,
(3) C
omm
u-ni
ty sp
ecifi
c co
ncer
ns,
(4) C
ross
-cul
tura
l co
ncer
ns10
Vella
et a
l. (2
015)
, UK
Exam
ine
in d
epth
the
expe
rienc
es a
nd
refle
ctiv
e vi
ews o
f pa
rent
s who
hav
e at
tend
ed a
‘Und
er-
stan
ding
You
r Chi
ld’s
B
ehav
iour
’ (U
YC
B)
grou
p to
und
erst
and
how
par
ents
mad
e se
nse
of p
artic
ipat
ing
in th
e gr
oup,
whe
ther
th
ey h
ave
been
abl
e to
im
plem
ent n
ew k
now
l-ed
ge a
nd sk
ills a
nd
parti
cipa
tion
may
hav
e be
en re
leva
nt a
ppro
xi-
mat
ely
10 m
onth
s afte
r co
mpl
etio
n
N =
10 p
aren
ts a
ged
18+
Solih
ull A
ppro
ach
par-
entin
g gr
oup:
‘Und
erst
andi
ng Y
our
Chi
ld’s
Beh
avio
ur’
(UY
CB
) (ht
tps :
//sol
ih
ulla
p pro
ac hp
are n
ting
.com
/)
Sem
i-stru
ctur
ed in
ter-
view
sIn
terp
retiv
e Ph
enom
-en
olog
ical
Ana
lysi
s (S
mith
et a
l. 20
09)
(1) T
wo
tiers
of s
atis
fac-
tion,
(2) D
evel
opm
ent a
s a
pare
nt, (
3) Im
prov
ed
self-
belie
f, (4
) Fol
low
-up
: the
‘Mat
thew
Effe
ct’
11Fu
rlong
and
McG
illow
ay
(201
5)*,
Irel
and
To a
sses
s lon
ger t
erm
ex
perie
nces
of t
he
Incr
edib
le Y
ears
BA
SIC
Pre
scho
ol/
Early
Sch
ool Y
ears
Pa
rent
Tra
inin
g Pr
o-gr
amm
e (I
YPP
) with
in
soci
ally
dep
rived
se
tting
s in
Irel
and,
w
ith a
key
focu
s on
inve
stiga
ting
the
key
faci
litat
ive
and
inhi
bi-
tive
fact
ors a
ssoc
iate
d w
ith tr
ial o
utco
mes
N =
28 C
auca
sian
Iris
h pa
rent
sIn
cred
ible
Yea
rs B
ASI
C
Pres
choo
l/Ear
ly S
choo
l Ye
ars P
aren
t Tra
inin
g Pr
ogra
mm
e (I
YPP
) (h
ttp://
ww
w.in
cre d
ible
ye
ars .c
om/)
Sem
i-stru
ctur
ed in
ter-
view
sC
onstr
uctiv
ist G
roun
ded
Theo
ry (C
harm
az
2006
)
(1) M
aint
aini
ng p
ositi
ve
outc
omes
, (2)
Rel
apse
in
pos
itive
out
com
es, (
3)
Div
ergi
ng p
aths
12M
ejia
et a
l. (2
015)
, Pa
nam
aTo
exp
lore
par
ents’
pe
rcep
tions
and
bel
iefs
ab
out c
hang
es a
fter
taki
ng p
art i
n th
e pr
ogra
m
N =
30 P
anam
ania
n pa
r-en
ts o
f ado
lesc
ents
Stre
ngth
enin
g Fa
mili
es
Prog
ram
me
(SFP
) 10
-14
(Mol
gaar
d an
d Sp
oth
2001
)
Sem
i-stru
ctur
ed in
ter-
view
sTh
emat
ic A
naly
sis
(Bra
un a
nd C
lark
e 20
06)
(1) C
hang
es in
the
child
, (2
) Cha
nges
in th
e Pa
r-en
t, (3
) Cha
nges
in th
e co
uple
, (4)
Cha
nges
in
the
inte
ract
ion
https://solihullapproachparenting.com/https://solihullapproachparenting.com/https://solihullapproachparenting.com/http://www.incredibleyears.com/http://www.incredibleyears.com/
-
184 Clinical Child and Family Psychology Review (2020)
23:176–204
1 3
Tabl
e 2
(con
tinue
d)
Aut
hors
, pub
licat
ion
year
, cou
ntry
Aim
s/ob
ject
ives
/rese
arch
qu
estio
nsPa
rtici
pant
saIn
terv
entio
nD
ata
colle
ctio
nbM
etho
d of
ana
lysi
sM
ain
them
es id
entifi
edc
13B
utch
er a
nd G
ersc
h (2
014)
, UK
To u
nder
stan
d th
e qu
alita
tive
expe
ri-en
ces o
f par
ents
of
child
ren
in th
e ea
rly
year
s who
wer
e id
enti-
fied
as b
eing
soci
ally
is
olat
ed a
nd/o
r hav
ing
diffi
culti
es re
latin
g to
thei
r chi
ld a
nd h
ad
take
n pa
rt in
the
Tim
e To
geth
er h
ome
visi
ting
inte
rven
tion
N =
7 w
hite
Brit
ish
par-
ents
age
d 26
–35
year
sTi
me
Toge
ther
[dra
win
g up
on p
rinci
ples
of
Peer
s Ear
ly E
duca
tion
Partn
ersh
ip (E
vang
elou
an
d Sy
lva
2011
) and
th
e So
lihul
l app
roac
h (D
ougl
as a
nd G
inty
20
01)]
Sem
i-stru
ctur
ed in
ter-
view
sIn
terp
retiv
e ph
enom
-en
olog
ical
Ana
lysi
s (S
mith
and
Osb
orn
2008
)
(1) T
he n
otio
n of
self,
(2)
The
pow
er o
f pla
y, (3
) In
fluen
tial r
elat
ions
hips
, (4
) The
mea
ning
of
soci
al is
olat
ion
14H
oltro
p et
al.
(201
4),
USA
To p
rovi
de a
bet
ter
unde
rsta
ndin
g of
the
proc
ess o
f cha
nge
with
in a
n ev
iden
ce-
base
d pa
rent
trai
ning
in
terv
entio
n: W
hat i
s th
e pr
oces
s thr
ough
w
hich
par
ents’
exp
eri-
ence
s in
the
PMTO
in
terv
entio
n le
d to
ch
ange
in th
eir p
aren
t-in
g pr
actic
es?
N =
20 w
hite
par
ents
ag
ed 2
8–64
yea
rsPa
rent
Man
agem
ent
Trai
ning
—th
e O
rego
n M
odel
(PM
TO™
) (F
orga
tch
and
Patte
r-so
n 20
08)
Sem
i-stru
ctur
ed in
ter-
view
sG
roun
ded
Theo
ry (G
la-
ser a
nd S
traus
s 196
7)(1
) PM
TO p
roce
ss o
f ch
ange
, (2)
Con
tent
of
PM
TO, (
3) P
MTO
m
etho
d of
del
iver
y, (4
) A
dditi
onal
cha
ract
er-
istic
s
15Es
tefa
n et
al.
(201
3),
USA
To e
xplo
re th
e na
ture
an
d co
-occ
urre
nce
of fa
mily
stre
ssor
s in
a sa
mpl
e of
par
ents
in
volv
ed in
the
child
-w
elfa
re sy
stem
who
ha
ve b
een
refe
rred
to
an in
tens
ive
ther
a-pe
utic
par
ent t
rain
ing
prog
ram
N =
21 p
aren
ts in
volv
ed
or a
t ris
k of
bec
omin
g in
volv
ed in
the
child
-w
elfa
re sy
stem
Nur
turin
g Pa
rent
s Pro
-gr
am (N
PP) (
http
s ://
ww
w.nu
rtu rin
gp ar
ent
ing.
com
/)
Sem
i-stru
ctur
ed in
ter-
view
sN
ot sp
ecifi
ed(1
) Cha
nge
met
hods
of
disc
iplin
e, (2
) Bet
ter
unde
rsta
ndin
g/to
ols f
or
copi
ng w
ith a
nger
, (3)
C
halle
nges
with
impl
e-m
entin
g ne
w p
aren
ting
prac
tices
, (4)
Lea
rnt
new
skill
s, (5
) Fel
t wel
l su
ppor
ted
by fa
cilit
ator
s an
d gr
oup
form
at
https://www.nurturingparenting.com/https://www.nurturingparenting.com/https://www.nurturingparenting.com/
-
185Clinical Child and Family Psychology Review (2020)
23:176–204
1 3
Tabl
e 2
(con
tinue
d)
Aut
hors
, pub
licat
ion
year
, cou
ntry
Aim
s/ob
ject
ives
/rese
arch
qu
estio
nsPa
rtici
pant
saIn
terv
entio
nD
ata
colle
ctio
nbM
etho
d of
ana
lysi
sM
ain
them
es id
entifi
edc
16C
ulle
n et
al.
(201
3), U
KTo
exa
min
e th
e im
por-
tant
fact
ors w
ith
resp
ect t
o in
terv
entio
n an
d th
e ex
perie
nces
of
both
par
ents
and
thos
e in
volv
ed in
the
deliv
-er
y of
the
prog
ram
mes
N =
133
pare
nts p
ar-
ticip
atin
g in
par
entin
g pr
ogra
mm
es a
cros
s lo
cal a
utho
ritie
s in
Engl
and
Trip
le P
; Inc
redi
ble
Year
s; F
amili
es a
nd
Scho
ols T
oget
her
(FA
ST);
and
the
Stre
ngth
enin
g Fa
mili
es
Prog
ram
me
10-1
4 (h
ttps :
//ww
w.tri
pl
ep.n
et; h
ttp://
ww
w.in
cre d
ible
year
s .com
/; ht
tps :
//ww
w.fa
mil
iesa
n dsc
ho ol
s.org
/; M
olga
ard
and
Spot
h 20
01)
Sem
i-stru
ctur
ed in
ter-
view
sTh
emat
ic A
naly
sis (
ref-
eren
ce n
ot p
rovi
ded)
(1) F
amily
issu
es, (
2)
Pare
ntin
g co
urse
s as
educ
atio
nal p
roce
sses
17H
ould
ing
et a
l. (2
012)
, C
anad
aTo
exa
min
e th
e pe
r-ce
ived
impa
ct, c
ultu
ral
acce
ptab
ility
and
exp
e-rie
nce
of th
e G
roup
Tr
iple
P P
ositi
ve
Pare
ntin
g Pr
ogra
m
N =
11 A
borig
inal
Can
a-di
an p
aren
tsG
roup
Trip
le P
Par
ent-
ing
Prog
ram
me
(http
s ://w
ww.
tripl
ep.n
et)
Sem
i-stru
ctur
ed in
ter-
view
sIn
terp
retiv
e Ph
enom
-en
olog
ical
Ana
lysi
s (C
olai
zzi 1
978)
(1) T
he h
elpf
ulne
ss o
f th
e pr
ogra
m, (
2) H
ow
pare
ntin
g be
havi
ours
ch
ange
d, (3
) How
ch
ildre
n’s b
ehav
iour
ch
ange
d, (4
) Pro
cess
es
that
faci
litat
ed le
arni
ng,
(5) B
enefi
ts o
f the
gro
up
form
at, (
6) C
ultu
ral
acce
ptab
ility
of s
trate
-gi
es a
nd p
roce
ss, (
7)
Cul
tura
l acc
epta
bilit
y of
in
dige
nous
reso
urce
s18
Furlo
ng a
nd M
cGill
oway
(2
012)
*, Ir
elan
dTo
exp
lore
: (1)
whi
ch
aspe
cts o
f the
pro
gram
w
ere
mos
t val
ued
by
pare
nts a
nd p
er-
ceiv
ed a
s pro
duci
ng
posi
tive
chan
ges;
(2)
wha
t cha
lleng
es th
ey
enco
unte
red
in le
arn-
ing
the
new
skill
s and
(3
) the
exp
erie
nces
of
the
smal
l num
ber o
f pa
rent
s who
dro
pped
ou
t of t
he p
rogr
am
N =
33 p
aren
ts (3
1 m
oth-
ers a
nd 2
fath
ers w
ith a
m
ean
age
34 y
ears
)
Incr
edib
le Y
ears
BA
SIC
Pres
choo
l/Ear
ly S
choo
l Ye
ars P
aren
t Tra
inin
g Pr
ogra
m (I
YP)
(http
://w
ww.
incr
e dib
le ye
ars
.com
/)
Sem
i-stru
ctur
ed in
ter-
view
sC
onstr
uctiv
ist G
roun
ded
Theo
ry (C
harm
az
2006
)
(1) M
echa
nism
s of
chan
ge, (
2) T
rials
of
pare
ntin
g, (3
) ‘Fa
ilure
to
laun
ch’
https://www.triplep.nethttps://www.triplep.nethttp://www.incredibleyears.com/http://www.incredibleyears.com/https://www.familiesandschools.org/https://www.familiesandschools.org/https://www.triplep.nethttp://www.incredibleyears.com/http://www.incredibleyears.com/http://www.incredibleyears.com/
-
186 Clinical Child and Family Psychology Review (2020)
23:176–204
1 3
Tabl
e 2
(con
tinue
d)
Aut
hors
, pub
licat
ion
year
, cou
ntry
Aim
s/ob
ject
ives
/rese
arch
qu
estio
nsPa
rtici
pant
saIn
terv
entio
nD
ata
colle
ctio
nbM
etho
d of
ana
lysi
sM
ain
them
es id
entifi
edc
19B
erm
udez
et a
l. (2
011)
, U
SATo
gai
n an
in-d
epth
un
ders
tand
ing
of
the
expe
rienc
es o
f M
exic
an–A
mer
ican
m
othe
r’s p
artic
ipat
ion
in a
par
ent e
duca
tion
prog
ram
me
N =
20 M
exic
an–A
mer
i-ca
n m
othe
rs p
aren
ting
alon
e
Pare
ntin
g Th
roug
h C
hang
e (P
TC) (
For-
gatc
h an
d D
eGar
mo
1999
)
Sem
i-stru
ctur
ed in
ter-
view
sH
euris
tic In
quiry
(Mou
s-ta
kas 1
990)
(1) P
artic
ipan
ts g
aine
d va
luab
le k
now
ledg
e re
late
d to
chi
ld re
arin
g pr
actic
es, (
2) P
artic
i-pa
nts g
aine
d a
heig
ht-
ened
awar
enes
s abo
ut
them
selv
es a
s mot
h-er
s, (3
) Cla
ss p
roce
ss
was
impo
rtant
, (4)
Ex
perie
nces
of t
akin
g th
e cl
asse
s var
ied
for
sam
ple,
(5) I
nter
view
pr
oces
s was
mea
ning
ful
and
empo
wer
ing,
(6)
The
rese
arch
ers’
exp
eri-
ence
s wer
e m
eani
ngfu
l an
d em
pow
erin
g20
Ow
ens e
t al.
(200
7),
USA
To e
xam
ine
pare
nts’
per
-ce
ptio
ns o
f bar
riers
to
parti
cipa
tion,
stre
ngth
s an
d w
eakn
esse
s of t
he
prog
ram
and
reco
m-
men
datio
ns fo
r fut
ure
prog
ram
min
g
N =
15 C
auca
sian
pa
rent
sC
omm
unity
-bas
ed,
beha
viou
ral p
aren
ting
prog
ram
(der
ived
from
D
efian
t Chi
ld p
rogr
am
(Bar
kley
199
7) a
nd th
e C
omm
unity
-Orie
ntat
ed
Pare
ntin
g Ed
ucat
ion
(CO
PE) P
rogr
amm
e (C
unni
ngha
m e
t al.
1996
)
Focu
s gro
ups
Focu
s Gro
up T
oolk
it (M
orga
n an
d K
rueg
er
1998
)
1) S
treng
ths o
f the
pa
rent
ing
prog
ram
, (2
) Wea
knes
ses o
f the
pa
rent
ing
prog
ram
, (3)
B
arrie
rs to
par
ticip
atio
n in
par
entin
g gr
oups
, (4
) Rec
omm
enda
tions
fo
r im
prov
emen
t of t
he
prog
ram
21Ru
ssel
l et a
l. (2
007)
, C
anad
aTo
det
erm
ine
pare
nt
view
s reg
ardi
ng th
e be
nefic
ial a
nd d
etri-
men
tal a
spec
ts o
f the
m
ulti-
face
ted
inte
rven
-tio
ns th
ey re
ceiv
ed
N =
24 p
aren
ts c
ultu
rally
di
vers
e pa
rent
s who
w
ere
refe
rred
by
child
pr
otec
tion
agen
cies
Proj
ect P
aren
t (no
refe
r-en
ce p
rovi
ded)
Focu
s gro
ups
Gro
unde
d Th
eory
(S
traus
s and
Cor
bin
1990
)
Maj
or th
eme:
reci
proc
al
mul
ti-sy
stem
inte
rven
-tio
ns, (
1) P
aren
t psy
cho-
logi
cal l
evel
: affi
rmin
g pa
rent
self-
wor
th, (
2)
Pare
nt–c
hild
leve
l: no
n-di
rect
ive
instr
uc-
tion,
(3) S
ocia
l-fam
ily
leve
l: pr
omot
ing
soci
al
conn
ectio
ns, (
4) S
ocia
l sy
stem
leve
l: em
pow
er-
ing
com
mun
icat
ion
-
187Clinical Child and Family Psychology Review (2020)
23:176–204
1 3
Tabl
e 2
(con
tinue
d)
Aut
hors
, pub
licat
ion
year
, cou
ntry
Aim
s/ob
ject
ives
/rese
arch
qu
estio
nsPa
rtici
pant
saIn
terv
entio
nD
ata
colle
ctio
nbM
etho
d of
ana
lysi
sM
ain
them
es id
entifi
edc
22Pa
tters
on e
t al.
(200
5)*,
U
KTo
repo
rt th
e us
eful
ness
of
the
prog
ram
me
to
the
pare
nts,
aspe
cts
they
foun
d he
lpfu
l and
w
hy, a
nd th
e ex
tent
to
whi
ch th
ey h
ad
obse
rved
cha
nges
in
thei
r ow
n an
d th
eir
child
ren’
s men
tal
heal
th a
nd b
ehav
iour
as
a re
sult
of th
e pr
o-gr
amm
e
N =
26 p
aren
ts (2
2 w
ho
atte
nded
at l
east
50%
of
the
prog
ram
me,
3
non-
atte
nder
s and
1
who
‘dro
pped
out
’)
Web
ster-S
tratto
n ‘P
aren
ts a
nd C
hild
ren
Serie
s’ p
rogr
amm
e (h
ttp://
ww
w.in
cre d
ible
ye
ars .c
om/)
Sem
i-stru
ctur
ed in
ter-
view
sG
roun
ded
theo
ry (G
lase
r an
d St
raus
s 196
7)(1
) Par
ents
nee
ds a
nd
prob
lem
s, (2
) Way
s in
whi
ch th
e pr
ogra
mm
e ha
d an
impa
ct o
n th
ese
need
s and
pro
blem
s, (3
) Pr
ogra
mm
e de
liver
y,
(4) A
spec
ts o
f the
pr
ogra
mm
e w
ith w
hich
so
me
pare
nts d
isag
reed
, (5
) Nee
ds n
ot m
et b
y th
e pr
ogra
mm
e.
23M
ockf
ord
and
Bar
low
(2
004)
, Uni
ted
Kin
g-do
m
To lo
ok a
t the
effe
ct o
f a
pare
ntin
g pr
ogra
mm
e on
eve
ryda
y fa
mily
liv
es. I
n pa
rticu
lar,
the
effec
ts th
e pa
rent
ing
prog
ram
me
may
hav
e on
bot
h pa
rent
s whe
n on
ly o
ne p
aren
t, m
ostly
th
e m
othe
r, at
tend
s the
pr
ogra
mm
e
N =
14 m
othe
rsW
ebste
r-Stra
tton
‘Par
ents
and
Chi
ldre
n Se
ries’
pro
gram
me
(http
://w
ww.
incr
e dib
le
year
s .com
/)
Sem
i-stru
ctur
ed in
ter-
view
sC
onst
ant C
ompa
rativ
e M
etho
d (G
lase
r and
St
raus
s 196
7)
(1) D
ifficu
lties
in ‘e
ngag
-in
g th
e pa
rtner
’ and
re
luct
ance
to a
ttend
th
e pr
ogra
mm
e, (2
) D
ifficu
lties
in c
hang
ing
the
esta
blis
hed
habi
ts o
f th
eir p
artn
ers,
(3) F
ind-
ings
the
time
to p
aren
t to
geth
er
24St
ewar
t-Bro
wn
et a
l. (2
004)
*, U
KTo
test
the
effec
tive-
ness
at o
ne y
ear o
f th
e W
ebste
r-Stra
tton
Pare
nts a
nd C
hild
ren
Serie
s gro
up p
aren
t-in
g pr
ogra
mm
e in
a
popu
latio
n sa
mpl
e of
pa
rent
s
N =
26 in
terv
entio
n gr
oup
pare
nts
Pare
nt a
nd C
hild
Ser
ies
Incr
edib
le Y
ears
pro
-gr
amm
e (h
ttp://
ww
w.in
cre d
ible
year
s .com
/)
Sem
i-stru
ctur
ed in
ter-
view
sG
roun
ded
Theo
ry (G
la-
ser a
nd S
traus
s 196
7)(1
) Im
pact
on
inte
rven
-tio
n gr
oup
pare
nts,
(2)
Spec
ific
impr
ovem
ents
in
thei
r chi
ldre
n’s
beha
viou
r, (3
) Im
prov
e-m
ent i
n th
eir r
elat
ion-
ship
with
thei
r chi
ld,
(4) D
ifficu
lties
with
the
prog
ram
me.
25W
olfe
and
Had
dy
(200
1), U
SATo
info
rm a
nd im
prov
e pa
rent
edu
catio
n eff
orts
by
prov
id-
ing
insi
ght a
bout
pa
rtici
pant
s’ p
erce
ived
ex
perie
nces
and
pro
-gr
amm
e im
pact
N =
15 m
othe
rs (1
1 W
hite
wom
en a
nd
4 A
fric
an A
mer
ican
W
omen
)
Liste
ning
to C
hild
ren
(LTC
) (W
olfe
199
9)Se
mi-s
truct
ured
inte
r-vi
ews
Con
tent
Ana
lysi
s (re
fer-
ence
not
pro
vide
d)(1
) Inc
reas
ed so
cial
sup-
port,
(2) H
eigh
tene
d se
lf-aw
aren
ess,
(3)
Impr
oved
par
entin
g sk
ills,
(4) E
nhan
ced
sens
e of
em
pow
erm
ent.
http://www.incredibleyears.com/http://www.incredibleyears.com/http://www.incredibleyears.com/http://www.incredibleyears.com/http://www.incredibleyears.com/http://www.incredibleyears.com/
-
188 Clinical Child and Family Psychology Review (2020)
23:176–204
1 3
Tabl
e 2
(con
tinue
d)
Aut
hors
, pub
licat
ion
year
, cou
ntry
Aim
s/ob
ject
ives
/rese
arch
qu
estio
nsPa
rtici
pant
saIn
terv
entio
nD
ata
colle
ctio
nbM
etho
d of
ana
lysi
sM
ain
them
es id
entifi
edc
26B
arlo
w a
nd S
tew
art-
Bro
wn
(200
1)*d
, UK
To g
ain
a be
tter u
nder
-st
andi
ng o
f par
ents’
ex
perie
nces
of a
pa
rent
ing
prog
ram
me
(e.g
. whe
ther
par
ents
ha
d fo
und
taki
ng p
art
in a
gro
up w
ith o
ther
pa
rent
s hel
pful
and
, if
so, i
n w
hat w
ays)
.
N =
11 p
aren
ts w
ho h
ad
atte
nded
at l
east
90%
of
the
prog
ram
me
Fam
ily L
inks
Nur
turin
g Pr
ogra
mm
e (h
ttps :
//fa
mil y
link s
.org
.uk/
the-
nurtu
ring-
prog
r am
me)
Sem
i-stru
ctur
ed in
ter-
view
sN
ot sp
ecifi
ed(1
) Rea
sons
for p
artic
ipat
-in
g in
the
prog
ram
me,
(2
) Ove
rall
feel
ings
an
d th
ough
ts a
bout
the
prog
ram
me,
(3) W
ays i
n w
hich
par
ents
ben
efite
d fro
m ta
king
par
t in
a pa
rent
ing
prog
ram
me,
(4
) Sup
port
in th
e ro
le
of a
par
ent,
(5) R
egai
n-in
g fe
elin
gs o
f con
trol,
(6) I
ncre
ased
feel
ings
of
empa
thy
and
abili
ty to
id
entif
y w
ith th
eir c
hil-
dren
, (7)
Asp
ects
of t
he
prog
ram
me
that
par
ents
di
d no
t lik
e.
a Onl
y da
ta fr
om p
artic
ipan
ts th
at m
eet t
he in
clus
ion
crite
ria fo
r the
revi
ew a
re p
rese
nted
b Oth
er m
etho
ds o
f dat
a co
llect
ion
may
hav
e be
en u
sed
in th
e in
clud
ed st
udie
s but
onl
y da
ta g
athe
red
from
inte
rvie
ws o
r foc
us g
roup
s is i
nclu
ded
in th
e re
view
c Onl
y th
emes
der
ived
from
par
ent i
nter
view
s or f
ocus
gro
ups h
ave
been
incl
uded
d In
studi
es m
arke
d w
ith a
n *
qual
itativ
e da
ta h
ad b
een
colle
cted
as p
art o
f a la
rger
fund
ed ra
ndom
ised
con
trol t
rial
https://familylinks.org.uk/the-nurturing-programmehttps://familylinks.org.uk/the-nurturing-programmehttps://familylinks.org.uk/the-nurturing-programme
-
189Clinical Child and Family Psychology Review (2020)
23:176–204
1 3
Tabl
e 3
Met
hodo
logi
cal q
ualit
y as
sess
men
t of i
nclu
ded
studi
es
Aut
hors
and
pu
blic
atio
n ye
ar
1. W
as th
ere
a cl
ear s
tate
-m
ent o
f the
ai
ms o
f the
re
sear
ch?
2. Is
a
qual
itativ
e m
etho
dolo
gy
appr
opria
te?
3. W
as th
e re
sear
ch
desi
gn
appr
opria
te
to a
ddre
ss th
e ai
ms o
f the
re
sear
ch?
4. W
as th
e re
crui
tmen
t str
ateg
y ap
prop
riate
to
the
aim
s of
the
rese
arch
?
5. W
as th
e da
ta c
ol-
lect
ed in
a
way
that
ad
dres
sed
the
rese
arch
is
sue?
6. H
as th
e re
latio
nshi
p be
twee
n re
sear
cher
an
d pa
r-tic
ipan
ts b
een
adeq
uate
ly
cons
ider
ed?
7. H
ave
ethi
cal i
ssue
s be
en ta
ken
into
con
sid-
erat
ion?
8. W
as th
e da
ta a
naly
sis
suffi
cien
tly
rigor
ous?
9. Is
ther
e a
clea
r st
atem
ent o
f fin
ding
s?
10. H
ow
valu
able
is
the
rese
arch
?
Tota
l sc
ore
(max
sc
ore =
10)
1W
ilson
et a
l. (2
018)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
10 (H
igh)
2G
arci
a et
al.
(201
8)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)0.
5 (C
an’ta
Te
ll)1
(Yes
)1
(Yes
)1
(Yes
)9.
5(H
igh)
3H
aske
tt et
al.
(201
8)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)0.
5 (C
an’t
Tell)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
9.5
(Hig
h)4
Coa
tes e
t al.
(201
7)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)10 (H
igh)
5H
artw
ig e
t al.
(201
7)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)0.
5(C
an’t
Tell)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
9.5
(Hig
h)6
Erra
zuriz
et
al.
(201
6)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)0.
5 (C
an’t
Tell)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
9.5
(Hig
h)7
Dup
pong
-H
urle
y et
al.
(201
6)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0 (N
o)0.
5 (C
an’t
Tell)
0.5
(Can
’t Te
ll)1
(Yes
)1
(Yes
)8
(Hig
h)
8Le
wis
et a
l. (2
016)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0 (N
o)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)9 (H
igh)
9M
ejia
et a
l. (2
016)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0.5
(Can
’t Te
ll)0.
5 (C
an’t
Tell)
1 (Y
es)
1 (Y
es)
1 (Y
es)
9 (Hig
h)10
Vella
et a
l. (2
015)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0.5
(Can
’t Te
ll)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)9.
5(H
igh)
11Fu
rlong
and
M
cGill
oway
(2
015)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0.5
(Can
’t Te
ll)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)9.
5(H
igh)
12M
ejia
et a
l. (2
015)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0.5
(Can
’t Te
ll)0.
5 (C
an’t
Tell)
1 (Y
es)
1 (Y
es)
1 (Y
es)
9 (Hig
h)13
But
cher
and
G
ersc
h (2
014)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
10 (Hig
h)
14H
oltro
p et
al.
(201
4)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)10 (H
igh)
15Es
tefa
n et
al.
(201
3)0.
5 (C
an’t
Tell)
0.5
(Can
’t Te
ll)0.
5 (C
an’t
Tell)
0.5
(Can
’t Te
ll)0.
5 (C
an’t
Tell)
0 (N
o)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)6.
5 (M
oder
ate)
16C
ulle
n et
al.
(201
3)1
(Yes
)1
(Yes
)1
(Yes
)0.
5 (C
an’t
Tell)
0.5
(Can
’t Te
ll)0
(No)
1 (Y
es)
0.5
(Can
’t Te
ll)1
(Yes
)1
(Yes
)7.
5(M
oder
ate)
-
190 Clinical Child and Family Psychology Review (2020)
23:176–204
1 3
Tabl
e 3
(con
tinue
d)
Aut
hors
and
pu
blic
atio
n ye
ar
1. W
as th
ere
a cl
ear s
tate
-m
ent o
f the
ai
ms o
f the
re
sear
ch?
2. Is
a
qual
itativ
e m
etho
dolo
gy
appr
opria
te?
3. W
as th
e re
sear
ch
desi
gn
appr
opria
te
to a
ddre
ss th
e ai
ms o
f the
re
sear
ch?
4. W
as th
e re
crui
tmen
t str
ateg
y ap
prop
riate
to
the
aim
s of
the
rese
arch
?
5. W
as th
e da
ta c
ol-
lect
ed in
a
way
that
ad
dres
sed
the
rese
arch
is
sue?
6. H
as th
e re
latio
nshi
p be
twee
n re
sear
cher
an
d pa
r-tic
ipan
ts b
een
adeq
uate
ly
cons
ider
ed?
7. H
ave
ethi
cal i
ssue
s be
en ta
ken
into
con
sid-
erat
ion?
8. W
as th
e da
ta a
naly
sis
suffi
cien
tly
rigor
ous?
9. Is
ther
e a
clea
r st
atem
ent o
f fin
ding
s?
10. H
ow
valu
able
is
the
rese
arch
?
Tota
l sc
ore
(max
sc
ore =
10)
17H
ould
ing
et a
l. (2
012)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
10 (H
igh)
18Fu
rlong
and
M
cGill
oway
(2
012)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0.5(
Can
’t Te
ll)0.
5 (C
an’t
Tell)
1 (Y
es)
1 (Y
es)
1 (Y
es)
9 (Hig
h)
19B
erm
udez
et
al.
(201
1)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)1
(Yes
)0.
5 (C
an’t
Tell)
0 (N
o)1
(Yes
)1
(Yes
)1
(Yes
)8.
5 (H
igh)
20O
wen
s et a
l. (2
007)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0.5
(Can
’t Te
ll)0.
5 (C
an’t
Tell)
1 (Y
es)
1 (Y
es)
1 (Y
es)
9 (H
igh)
21Ru
ssel
l et a
l. (2
007)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0 (N
o)0
(No)
0.5
(Can
’t Te
ll)1
(Yes
)1
(Yes
)7.
5 (M
oder
ate)
22Pa
tters
on
et a
l. (2
005)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0.5
(Can
’t Te
ll)0.
5 (C
an’t
Tell)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
9 (H
igh)
23M
ockf
ord
and
Bar
low
(2
004)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0 (N
o)0.
5 (C
an’t
Tell)
0.5
(Can
’t Te
ll)1
(Yes
)1
(Yes
)8
(Hig
h)
24St
ewar
t-B
row
n et
al.
(200
4)
1 (Y
es)
0.5
(Can
’t Te
ll)1
(Yes
)1
(Yes
)1
(Yes
)0
(No)
1 (Y
es)
0.5
(Can
’t Te
ll)1
(Yes
)1
(Yes
)8
(Hig
h)
25W
olfe
and
H
addy
(2
001
(Yes
))
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0 (N
o)0
(No)
0.5
(Can
’t Te
ll)1
(Yes
)1
(Yes
)7.
5 (M
oder
ate)
26B
arlo
w a
nd
Stew
art-
Bro
wn
(200
1)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
1 (Y
es)
0.5
(Can
’t Te
ll)0
(No)
0.5
(Can
’t Te
ll)1
(Yes
)1
(Yes
)8
(Hig
h)
% o
f Inc
lude
d stu
dies
rate
d as
1:‘Y
es’
9692
9692
8823
5873
100
100
a ‘C
an’t
tell’
indi
cate
s the
requ
ired
info
rmat
ion
was
unc
lear
or e
vide
nce
prov
ided
by
study
aut
hors
in th
e te
xt w
as in
suffi
cien
t
-
191Clinical Child and Family Psychology Review (2020)
23:176–204
1 3
overwhelmed or ‘out of control’. One parent noted, “we were all
overwhelmed, really, we all arrived here very desper-ate”
(Errázuriz et al. 2016, p. 3444) and another “I failed
completely to find a way to cope… I felt like I was out of control”
(Patterson et al. 2005, p. 57).
A number of authors noted that parents feared being judged to be
a ‘bad parent’ and felt obligated to participate in a parenting
programme, acquiescing despite initial pes-simism about how
effective it would be. Such feelings were more common amongst
parents that were mandated to attend as part of child-welfare
processes. In contrast, other par-ents saw the invitation to attend
a parenting programme as a recognition of the difficulties they
were experiencing. A frequently cited reason for attending a
parenting programme was a commitment to “be a better parent”
(Hartwig et al. 2017, p. 506).
Subtheme 1.2: Outcomes
Subtheme 1.2.1: Changes in Parent Subtheme 1.2.1.1:
Overcoming Barriers to Engagement: Parents commonly described a
shift from the initial pessimism or reluctance, described prior to
the parenting programme, to an intrinsic willingness to
participate:
“So like I said, the first two sessions I’m like whatever, I
gotta come here. I don’t feel like being here, but after the third
or fourth session it really made me want to be here more ‘cause I
wanted to learn and figure out what did I do wrong or what was I
not doing right with these kids.” (Garcia et al. 2018, p.
292)
“At first, like the first couple of weeks, I was like I can’t
believe I have to do this, and it’s ridiculous. But it was all
right. I mean the group, we got to know the people in our group and
stuff, and they were people just like us. There was a couple that
was our age, cou-ples that were older. I liked the group thing, the
way it was set up like that.” (Estefan et al. 2013, p.
206)
Subtheme 1.2.1.2: Skill Development: Parents frequently
described acquisition of new skills and the reinforcement of
existing skills as an outcome of attending the parenting
pro-gramme. Some of the key skills that parents reported were
learning emotional regulation strategies to support them to remain
calm resulting in a reduction in shouting, physical punishment and
the use of punitive parenting strategies. In turn, parents were
able to employ the alternative strategies they learnt on the
parenting programme:
We learned about escalating, that it is not necessary to yell
and keep punishing, that you need to make clear,
Fig. 2 Diagram depicting themes and subthemes in the thematic
synthesis
-
192 Clinical Child and Family Psychology Review (2020)
23:176–204
1 3
precise rules and for the child to understand you so that things
work. (Errázuriz et al. 2016, p. 3445)
I do a lot less shouting and I’d occasionally smack but I don’t
do that now… learning to reward rather than punish, I don’t think
we hardly [ever] punish now, do we… (Barlow and Stewart-Brown 2001,
p. 124)
Subtheme 1.2.1.3: Developing Understanding and the Relationship
with Child: Parents commonly reported an improved relationship with
their child as an outcome of attending a parenting programme. In
addition, par-ents described improved communication with their
child, increased capacity to empathise with their child, feeling
closer to their child, increased affection, prioritising spend-ing
time playing with their child, establishing age-appropri-ate
expectations, recognising the importance of listening to their
child and seeking an understanding of their behaviour:
It’s just completely changed both of us, I think, in our outlook
to each other as well. We’re enjoying each oth-er’s company now.
We’re not just arguing constantly. It’s changed our lives. It
really has given me my daugh-ter back. (Cullen et al. 2013, p.
1037)
Um, the one thing that I would say was the most help-ful was
that I recognized that my children have the same feelings and
anxieties as adults have, and for some reason I think adults have
this misconception that they can speak to children any way that
they like. That they don’t have the [same] feelings, you know, and
I think that has been really helpful for me, just to recognize that
sometimes [that] they need to talk about things as well. And it is
often harder for kids to talk about things because they don’t have
the vocabulary, they don’t have the words to express the way that
they are feeling, and that it is up to me to try and [help them to]
express how they are feeling, you know. A
